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目的探讨多层螺旋CT(MSCT)在肝细胞癌(HCC)肝动脉化疗栓塞中的表现特点及其介入治疗中的指导意义。方法45例肝癌患者行肝动脉化疗栓塞前同期分别行MSCT和DSA2种检查。MSCT应用三维容积再现(VRT)、最大密度投影(MIP)或多平面重组(MPR)技术观察腹腔动脉的解剖及走行分支,比较CT与DSA对病灶、合并症的显示情况及肿瘤的血供情况等。结果45例患者,MSCT发现病灶167个、门静脉癌栓11例、动脉静瘘12例;DSA发现病灶172个、门静脉癌栓8例,动静脉瘘15例。MSCT与DSA比较,DSA对肿瘤的数目显示率略高于MSCT,但差异无统计学意义。MSCT能够显示腹腔动脉及其主要分支的三维结构,优于DSA,观察与腹主动脉夹角较DSA更方便;MSCT发现肝动脉起源变异4例,与DSA完全符合。结论MSCT对肝细胞肝癌肝动脉化疗栓塞有重要指导意义。
Objective To investigate the characteristics of multi-slice spiral CT (MSCT) in the treatment of hepatocellular carcinoma (HCC) with chemoembolization and its guiding significance in interventional therapy. Methods Forty-five patients with hepatocellular carcinoma underwent hepatic arterial chemoembolization (MSCT) and DSA (DSA) before the embolization. MSCT was used to observe the anatomy and branches of celiac artery by three-dimensional volume rendering (VRT), maximum density projection (MIP) or multiplanar reorganization (MPR). CT and DSA were compared between the lesions and complications and the blood supply of tumor Wait. Results There were 167 lesions in MSCT, 11 tumor emboli in portal vein and 12 in arteriovenous fistula in 45 patients. There were 172 lesions found in DSA, 8 tumor thrombosis in portal vein and 15 in arteriovenous fistula. Compared with DSA, DSA showed a slightly higher number of tumors than MSCT, but the difference was not statistically significant. MSCT can show the three-dimensional structure of the celiac artery and its main branches, superior to the DSA, the angle between the aorta and the abdominal aorta is more convenient than the DSA; MSCT found that the origin of hepatic artery in 4 cases, consistent with the DSA. Conclusion MSCT has important guiding significance for hepatic arterial chemoembolization in hepatocellular carcinoma.